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Home My WebLink About1549 Tustin Ave - Building Permits • , S 4`aCITY OF COSTA MESA -4 epee BUILDING DIVISION >:f rr�' ,r, : DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1iii • PERMIT M07-00084 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1549 TUSTIN AV Status: ISSUED Suite No Applied: 02/13/2007 Issued: 02/13/2007 Vicinity: Parcel Number: 42531128 Applicant: FONZ RODRIGUEZ -. - ISSUED BY: CRC--'-- Address: 7050 LAMPSON AV - Phone: 714-530-7320 GARDEN GROVE,CA Zip: 92841 t , Owner: -HARRIS, MARIE J TR Address: 1549 TUSTIN AVE i -• � t 4 Phone: EX111 � COSTA MESA,CA ,, Zip: 92627 . t ' DATE •, - v Contractor: EMPIRE PLUMBING Address: 7050 LAMPSON AV ' Phone: 714-530-7320 GARDEN GROVE,CA Zip: 92841 License:794154 SCOPE OF PERMIT • NEW FAU AND<100K BTU FEE SUMMARY ' "Quantity Quantity ISSUE FEE $23.50 . _ Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80' 1 - Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 ' 0 - Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 - Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 • Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 Q _ Compressors/Absorption Systems Gas Piping $6.15,._ 1 .. Up to 3 hp/100k BTU $0.00 0 • Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 • Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers ':' '' $0.00 0 3 To 15 hp $0.00 0 ' Inst or Relocate Appl Vent \ $0:00 0 , , - 15 to 30'hp_, $0.00 0 Air Handlers< 10000cfm $0.00 ..,0 30 to 50 hp $0.00 0 Air Handlers>.10000cfm \ '$0.00 0 - Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater - $0.00 0 _ Investigation Fee $0.00 Plan Check Fee - $0.00 Reinspection Fee - $0.00 TOTAL CALCULATED FEES $44.45 COMMENTS/SPECIAL CONDITIONS • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)7545626 2446-46(WOO) 1 niessiosimilm.mm WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the „ark for which this permit is issued. 'I have end will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. .--. My word(e compensation Insurance carrier and policy number are: f--_carrier: / Y («(`✓1r.L Policy.Number:-w F(Joob3 I ,-n (This section need not he completed if the permit is valued at one hundred dollars($100)or less.) O I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro ' ons. I CApplicant Signature: // Date:-. ,�"V3-07 WARNING:FAILURE TO SE RE WORKERS'COMPENSATION OVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licenspd upper prov}siions of Chapter 9(commencing with Section 7000)of Division 3.of.the Busines end Pr fessions Code,and my license is in full :-force end effect:Lica /97/ Stet Lclass -. r 36,1 /o` Po , %Lz .. - rectors Signature: e=ig. ` ”- Da{e: - /3 -r. 7 _ CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: _ _ __ Lenders Address: Signature: Date: • OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she,is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). O I,as owner of the properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2.Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety.as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions.that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). • 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No ' (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any - one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation.certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ....i r.. r.. 4 If an RMPP is presently ntlyfly required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No .t... ian ... ..ta . 8 (If'yes",attach certificate offcompliance from thee appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. /" Signature 0 �:•al__• ner(s) - Date y / LApQDr`• prized A..lican , sate__ CODE• INSPECTION TYPE 2A1 INTRIAL4 CODES INSPECTION TYPt DATE 1NTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical ei -1 ^09 46/ ' 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall _ 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site ' ' :204.-....,Final,Demolition-,„...,,.a........-,,,,..,a.-- - "„_. ,.._250, _,,,Final Building/Occupency.,"„„„.„,,,„, _„„„ • — --- First r/ura'mail � UNITEDSTATES ., ORM 3547 fee due 50 _ Postage awl Ft'SI'mil i�® POSTAL SERVICE! 0 usl's �walrlrled Data l'rrnril No. 1,10 V MJW enrasmn o4ca CITY OF COSTA MESA j "°W'r::}t:'4"? c•cvmscn:T PO 00%IMO ^I. y L.• COSTA ucSA.0 lF0futiADM•CEG - c 4 i9 ADDRESS SERVICE REQUESTED ......---- LO \2 MARIE J HARRIS 1549 TUSTIN AV COSTA MESA CA 92627-3263 _;.t- .C037 . .. IIJm,i,LIL,,iLIL„LJi.,i I,Ih, LJ,,U I,iI.uJI----.. . -..J I/ARRIS TO THE POSTMASTER OF OLD: - /549%USTINAVli COSTA MESA CA 92627-3263 PO BOX 1200 NI IV: 197/2 MACARTI/UR ltLVU SDE 222 COSTA MESA CA 92628-9998 IRVINE CA 926E2-2407 ntr2m3149184&13670194952cl:1pne:20;SI1118cl:21m1I1%9 III I I II I it III I I III 11 1 11 II 1 1 1111 1 1 nu 1 11 1 1 .. . IF 1 11 11 1 1 11 1 11 nF 4��.�' :;. CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT -6.✓ r PERMIT yERMIT NUMBER B99-00343 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1549 TUSTIN AV Status: ISSUED Suite: Applied: 03/11/1999 Vicinity: Issued: 03/11/1999 Parcel Nunmber: 42531128 Zoning: Applicant: YOUNG, MICHAEL Address: 01112 E.CHESTNUT Phone: 714-753-5444 SANTA ANA CA Zip: 92701 •Owner: HARRIS, MARIE J TR Address 1549 TUSTIN AVE Phone: COSTA MESA,CA Zip: 92627 Contractor: YOUNGS ROOFING CO., INC. Address: 01112 E.CHESTNUT Phone: 714-753-5444 SANTA ANA CA Zip: 92701 License: 568560 Arch : Eng: Address: Address: • Phone: Phone: Zip License: Zip: License: SCOPE OF PERMIT TEAR OOF WOOD SHINGLES OVER THE HOUSE SIDE INSATLL 7/16 OSB AND REROOF WITH 30 YEAR COMP.SHIGLES. GO WITH 1 LAYER OF COMP.OVER EXIST. 1 LAYER OF COMP.ON THE GRAGE SIDE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6,500.00 Permit: $124.75 Claim Valuation: $6,500.00 SMIP Res: $0.65 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.40 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: EXPIRATION: This permit shall automatically expire and become void if work is not commenced within,180 days,or if work is suspended or abandoned fora period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)7545626 DECLARATIONS • WORKERS'COMPENSATION DECLARs ,,JN: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have end will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. It I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier. LGS r 0 r // Policy Number W I 0 S €8000.g— (This 0 0 b S (This section need not be completed it the permit is valued at one hundred dollars(5700)or less.) ❑ I certify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these •rovisions. q } Applicant Signature: A. 4 _ Date: 3– 11 -' r( / WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(St CO.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Sectio/n7 000)of Division 3 of the Business anQ PrQfessions Code,and my license is In full force and effect.Llc.a S C.ca. S (00 ! Class a C– 3') 7 0 Contractor's Signature: �j4 Date: 3-11 –9 4 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or Improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or Improve for purpose of sale.). ❑ I,as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,faisework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 if an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application agernit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 WII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Alr Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (if yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given Is correct. I agree to comply with all slate laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. S nature Of Legal Owner(s) / Date An uthorized Applicant Date CODE L INSPECTION TYPE QAff MD= CDDH INSPFCIIOIN TYPE DATE MEALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final q 208 Final Plumbing 200 Final Re-Roof C-/7""'q/ 210 Final Electrical 201 Final Block/Retaining Wall _ 212 Final Fire Prevention 202 Final Factory Flre Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 244646 911 M6 . CITY OF COSTA MESA ! r` 4 BUILDING DIVISION )• . tiro DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER �• PERMIT E07-00117 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.EIs€CTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1549 TUSTIN AV Status: ISSUED Suite No Applied: 02/13/2007 Vicinity: Issued: 02/13/2007 Parcel Nunmber: 42531128 Applicant: FONZ RODRIGUEZ Address: 7050 LAMPSON AV /� - Phone: 714-530-7320 ISSUED BY: v GARDEN GROVE,CA Zip 92841 Owner: HARRIS,,MARIE J TR Address 1549 TUSTIN AVE . - Phone: COSTA MESA,CA Zip: 92627 Contractor: EMPIRE PLUMBING Address: 7050 LAMPSON AV - Phone: 714-530-7320 GARDEN GROVE,CA Zip: 92841 License:794154 . . SCOPE OF PERMIT NEW FAU AND<100K BTU 1 RESID.APPLIANCE FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 ' Standing Section $0.00 0 New Res(1-2 units) $0.00 - 0Misc Electrical Equipment $0.00 0 _ New Res(3+units) $0.00 0 - Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $1.10 . 1 ' up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 - Low Volt Wiring System/Ckt $0.00 0 Service to 200a - $0.00 0 7. Misc.Conduit $0.00 0 Service to 1000a _ $0.00 0 Misc.Conductor $0.00 0 Service over 1000a '$0.00 0. Circus(gen or ride) $0.00 0 Motors to 1hp , '$0.00 - ,0 Circus(mech ride or lights) . $0.00 0 Motors to 10hp . $12.30 " I Christmas Tree Stand $0.00 0 Motors to 50hp, ', $0.00 : - , 0 Fireworks Stand $0.00 0 Motors to 100hp '$0.00 0- Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00. 0 - Investigation Fee $0.00 Sub panel to 200a $0.00 < - 0 Plan Check Fee $0.00 Pole Light Pkg '$0.00 0) Reinspection Fee $0.00 Sign Circuits - $0.00. . '0;- Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $36.90 Intermed Pole $0.00 0. • COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,$ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned " for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-48(WOO) DECLARATIONS I WORKERS'COMPENSATION DECLARATION: . - • I hereby affirm under penalty of perjury one of the following declarations: • El I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ark for which this permit isk issued. haveand will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. sd de workers'z� co pensatlon Insurance carder and policy number are: ,! // CCartier .. ././1/102r7 1r ! PoflcyNu'mber': W/- ^,9/03/4-9/ --(This section neeot be completed if the permit is valued et one hundred dollars($100)or less.) 0 I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these vvMons. - -.q Applicant �Y �/ .D�e f,2 j 'P7 -WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COY GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 'THOUSAND DOLLARE($100,000),IN ADDITION TO THE TMST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licen yfddeer provisl s of Chapter 9(commencing with Section 7000)of Division 3'of the Busine3ss�,and Pr fessions Code,and my icense is in full force and'effect.�Lic.a-1 5` �s LClass:#? C-_3" /0 to C -coontradofs Signal rU e: (CG. 'Y1��3 Daie:. 9 -�� -�7 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency 1or the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-properly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap,3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 9 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this.application aEEermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct, I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date a_ e�®►.a -_. �� -/3-p7- iz,%And/Or Authorized Apr . t'i k-Date,,,`')`: V CODE* INSPECTION TYPE DATE INTITIALS CODE 1 INSPECTION TYPE pl_crE JNTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing �f 200 Final Re-Roof 210 Final Electrical 3'z2-C) (S C 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site ,204. .,.F,inal,Demolition.., _,,,,_ti.., , - -- ., ,_,250, Final Building/Occupancg,,,,,, „�, zx OWNER TA PFRTE, LILLIAN DATE 4_3_68 JOB ADDRESS 1549 Tustin Avenue BUILDING PERMIT NO. 28409 m GENERAL CONTRACTOR Charles sutternield DESCRIPTION of WORK Attached Garage Addition 4 SAP No. 7q_261�_IyQ LOT 13 TRACT 1775 FIRE ZONE VALUE $1.050.00 INSPECTIONS Signature Dole GROUP 3 TYPE V ZONE R-2 SOIL PERMITS ISSUED GAS SUBCONTRACTOR Date I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND U P WER fl ROUGH WIRING Y ��`�6 C)' Heating and Vent. TRENCHES ORMS STEEL REINF. 0 c-- .21/�� FLOOR SYSTEM /// / BOND BEAM n STEEL REINFORCE n /�^ �/ SHEATHING /U` C FRAME AND FLASHING e LATHING — IN U OUT 'A nC yam/Z/to Vv�/p'p PLASTER, BROWN COAT ! C STRUCTURAL, FINAL --_[[[�T �} Ele tr' /J HEATING, VENT., REFRIG. AND A.C., FINAL 16!/q ip `j JD,/4 nlS K PLUMBING, FINAL AND GAS TEST n xi / ELECTRIC, FINAL //L/b I• BUILDING, FINAL C